Individual
LUIS ERNESTO AREVALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 HARMON MEADOW BLVD FL 4, SECAUCUS, NJ 07094-3600
(201) 590-6700
Mailing address
PO BOX 2036, LAKEWOOD, NJ 08701-8036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
07/05/2022
Last updated
07/05/2022
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